INTRODUCTION: The insufflations of CO2 into the abdomen during laparoscopic surgery can cause gastric distention and gastroesophageal reflux. Devices used for keeping airway patent in difficult airway cases gained importance. In this study we compared the stress response and side effects of endotracheal intubation, ProSeal LMA and Supreme LMA in laparoscopic cholecystectomy cases.
METHODS: A total of 120 adult patients, classified as ASA I-II and undergoing elective laparoscopic cholecystectomy (duration 12 h) were randomly allocated to one of three groups: endotracheal intubation group, ProSeal LMA group and Supreme LMA group.
RESULTS: There was no statistically significant difference between the preoperative measurements of cortisol levels in all groups. The cortisol levels 1 min after intubation in group ETT was significantly higher than the cortisol levels measured in group ProSeal LMA and Supreme LMA. Peripheral oxygen saturation, end-tidal CO2, peak pressures, gastric and nasopharyngeal pH measurements were not different between groups. Hoarseness at postop 1 hour was found to be significantly higher in the group endotracheal intubation. Symptoms of hoarseness, sore throat and dysphagia were lower in the group ProSeal LMA and group Supreme LMA than that of the group endotracheal intubation. Insertion duration and insertion attempt number were not different between ProSeal LMA and Supreme LMA groups.
DISCUSSION AND CONCLUSION: We concluded that PLMA and SLMA can be preferred instead of endotracheal intubation in laparoscopic surgical cases to provide effective ventilation with lesser side effects.